As establishing a set of clinical criteria for diagnosis of hemihyperplasia is difficult, the dictum is often used that the clinician should be able to see the asymmetry "from the end of the bed".

The two main surgical options for the treatment of uneven leg lengths are shortening and lengthening.

Leg lengthening procedures are more painful, involving the insertion of pins to be turned, moving parts of the bone apart (Ilizarov's method).

This process is reserved mainly for patients with a discrepancy greater than 4 centimetres (1.6 in) although some leg lengthening procedures are now done cosmetically.

Nonsurgical options include attachment of a lift to the shoe, allowing the patient to walk normally.